‘This would be life-changing’: Woman says insurance won’t cover weight loss surgery

ROCK HILL, S.C. — A Rock Hill woman said she’s tried all sorts of things to lose weight, but nothing has worked. Now, she thinks her best option is weight loss surgery, but she said her health insurance won’t cover it.

“It’s always just been a struggle my whole life,” Maria Basini told Action 9′s Jason Stoogenke. “You grow up heavy and you’re teased as a kid. It takes its toll on you, you know.”

Basini said she tried dieting, exercise and even tactics that aren’t very safe.

“I started smoking. I was like, well, if I start smoking, maybe it’ll stop my urge to want to eat,” she said. “Nothing seems to work. Something like this would be life-changing.”

She told Stoogenke that her doctor approves of the surgery but that her insurance provider, Cigna, won’t cover it.

“You’re willing to pay for diabetes medication and high blood pressure medicine and all these things that go with the side effects of being overweight, but you won’t pay for a surgery that could offset all of that and help me lead a long, healthy life. It doesn’t make any sense,” Basini said.

Stoogenke asked Cigna, along with Aetna, Blue Cross, Humana, Medicare and UnitedHealthcare, for their policies regarding the surgery. Cigna wouldn’t discuss Basini’s case with Action 9 for privacy reasons but it, along with most of the others, did state that weight loss (or bariatric) surgery is only covered if it’s “medically necessary.”

A Cigna representative told Stoogenke “bariatric surgery coverage is an option available under Cigna’s medical plans, and plan providers can choose to include it. The majority of Cigna customers who are insured through their employer have coverage, but some do not.”

The Mayo Clinic suggests that “you may need to provide documented evidence that you weren’t able to lose enough weight with a supervised program of diet and exercise.”

Piedmont Medical Center in Rock Hill said a patient may need to show a history of obesity and related health issues.

Stoogenke suggests that if you are considering the surgery, ask your doctor for help getting coverage and inquire about discounts if you are paying out of pocket.

He said some hospitals may offer financial assistance, and the cost may vary at different hospitals.

Depending on the price, you may also get a medical tax break that can offset some of the cost.

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